【作者】 任菁菁；

【机构】 浙江大学附属邵逸夫医院；

【摘要】 目的探讨在社区保健机构中就诊病人躯体形式障碍的患病率,以及与其他精神疾病的共病率、保健资源的使用情况。方法采用症状自评量表、焦虑自评量表、抑郁自评量表对社区保健机构处连续就诊的患者进行调查。结果共筛查289位连续性就诊的患者,55位患者符合《中国精神障碍分类与诊断标准》(CCMD-3)中躯体形式障碍的诊断标准, 最常见亚型为躯体化障碍,17例,占就诊病人总数的5．88％,最常见症状为自主神经症状。本症与焦虑症的共病率47．27％,与抑郁症的共病率21．82％。全科医师对本症的识别率 63．64％。55例患者在过去一年里平均就医11．2次。结论躯体形式障碍在社区保健机构中有较高的患病率,与焦虑症、抑郁症亦存在较高的共病率,其就医次数多而治疗效果差, 全科医师对于本症的识别是目前减少保健资源过度利用的重要途径之一。更多还原

【Abstract】 Objective To inqure the prevalence rate of somatoform disorders (SDs) in community health care institution, and the comorbidity between SDs and other mental disorders, utilization of the health care resources. Methods Patients consetively consulting their general practitioners were investigated with self-rating symptom scale SCL-90.zung self-rating anxiety scale SAS.zung self-rating depression scale SDS. Results 289 patients were screened with SCL-90. The study showed that 55 patients (19.03%) fulfilled the diagnostic criteria for CCMD-3 SDs. The most frequent diagnosis was somatization disorder,for which 5.88% of the patients fulfilled the criteria. The most frequent symptom was autonomous dysfunction.The comorbidity between SDs and anxiety disorder was 47.27%, the comorbidity between SDs and depression was 21.82%. The general practitioners identified 63.64% of the patients with CCMD-3 criteria.In the past one year, the 55 patients with SDs went to see doctors 11.2 times on average. Conclusion SDs had a high prevalence rate in community health care institution.A high comorbidity between SDs and other mental disorders was found. The patients with SDs went to see doctors frequently and most of them dissatisfied with the effects of the therapy. It is one of the important ways that the general practitioners’ identification for SDs to reduce the heavy use of the health care resources.更多还原